Key result
PRT-guided tailored DAPT cuts procedural thromboembolic complications ~60% vs conventional therapy.
Why the study?
Clopidogrel-based DAPT has a high proportion of hyporesponders, prompting evaluation of tailored DAPT using prasugrel or ticagrelor guided by platelet reactivity testing.
Does PRT-guided tailored DAPT using prasugrel or ticagrelor reduce procedural thromboembolic complications compared to conventional clopidogrel-based DAPT in patients undergoing endovascular treatment for intracranial aneurysms?
Meta-Analysis (n=2,557)
Does PRT-guided tailored DAPT using prasugrel or ticagrelor reduce procedural thromboembolic complications compared to conventional clopidogrel-based DAPT in patients undergoing endovascular treatment for intracranial aneurysms?
Relative Risk: 0.4 (95% CI 0.22–0.74)
p-value: p=0.004
PRT-guided tailored DAPT using prasugrel or ticagrelor significantly reduces thromboembolic complications without increasing bleeding risk in patients undergoing endovascular treatment for intracranial aneurysms.
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Supports tailored DAPT with prasugrel/ticagrelor to cut TEC in neurointerventions; confirms benefit of reactivity-guided switching without excess hemorrhage.
Jang et al. (2023) conducted a meta-analysis in Intracranial aneurysms (n=2,557). Platelet reactivity test (PRT)-guided tailored DAPT using prasugrel or ticagrelor vs. Clopidogrel-based conventional non-tailored DAPT was evaluated on Procedural thromboembolic complication (TEC) (RR 0.40, 95% CI 0.22 to 0.74, p=0.004). PRT-guided tailored DAPT with prasugrel or ticagrelor significantly reduced the risk of procedural thromboembolic complications compared with conventional non-tailored therapy (RR 0.40; 95% CI 0.22-0.74; P=0.004).
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